Gynaecology - Sexually Transmitted Infections (Discharge) Flashcards
Genital Infections:
- Discharge
- Lesions
Need to look at the following:
- Description, pH, Microscopy - Discharge
- Pain, What does it look like - Lesions
Genital Infections that cause discharge?
- Bacterial Vaginosis
- Trichomoniasis
- Candidiasis
- Neisseria Gonorrhoea
- Chlamydia Trachomatis
Genital infections that cause lesions?
- Trepomema Pallidum - Spirochaete bacterium, can cause syphilis
- Genital Herpes
- Condyloma Acuminata - HPV, anal neoplasia
- Haemophilus Ducreyi - Chancroid
- Lymphogranuloma venereum - Caused by 3 serovars of Chllamydia Trachomatis, not caused by same bacteria that causes genital chlamydia
- Granuloma Inguinale - Known as Donovanosis caused by Klebsiella granulomatis
Bacterial Vaginosis - Gardnerella
Bacterial Vaginosis - Gardnerella:
- Description: Watery/thin/grey, white - FISHY ODOUR
- pH - >4.5
- Microscopy - Clue cells = epithelial cells covered in blue or purple coating
- Treatment - Metronidazole
Genital Infections that can cause discharge - Trichomoniasis
Trichomoniasis:
Description - Green frothy discharge
pH - >4.5
Microscopy - Motile trichomonads with flagella
Treatment - Metronidazole -Treat partner
Bacterial Infections that cause discharge - Candidiasis?
Candidiasis: (Discharge)
Discription - Thick, White
pH - < 4.5 (low pH is unique)
Microscopy - KOH prep with pseudohyphae
Treatment - Topical azoles or oral fluconazole
Risk Factors - Recent anti-biotics, diabetes, oral contraceptives
Genital Infections that cause discharge:
Neisseria Gonorrhea
Chlamydia Trachomatis
Neisseria gonorrhea/Chlamydia trachomatis:
Description - Prurulent discharge
Microscopy - Gram negative diplococci (GC)/ Gram negative intracellular (Chlamydia)
Treatment - Ceftriaxone (GC): +Azithromycin or doxycycline (Chlamydia), usually treat both
Presentation - Sick, (pain/nausea/vomitting/fever) and cervical discharge/cervical motion tenderness
GonorrheaChlamydia - PID: Pelvic inflammatory disease
Complications of PID - Infertility, Ectopic pregnancy, Fitz-Hugh-Curtis syndrome: involving liver capsule inflammation leading to the creation of adhesions: Can cause upper right quadrant pain
Genital Infections that cause lesions:
Genital Infections that cause Lesions:
- Treponema pallidum
- Genital Herpes
- Condyloma acuminata
- Haemophilus ducreyi
- Lymphogranuloma venereum (Chlamydia)
- Granuloma inguinale (Klebsiella or Calmmatobacterium aka Donovanosis
Genital Infections that cause lesions:
‘Painless’
- Treponema pallidum
- Condyloma acuminata
- Granuloma inguinale
- Klebsiella Donavanosis
Genital Infections that cause lesions:
‘Painful’
Painful:
- Genital Herpes
- Haemophilus ducreyi (Chancroid)
- Lymphogranuloma venereum (Chlamydia trachomatis)
Genital Infections that cause lesions:
‘No pain’
Painless:
- Treponema pallidum (Syphyllis)
- Condyloma acuminata (HPV)
- Granuloma inguinale (Klebsiella)
Genital Infections that cause lesions:
‘No pain’
- Treponema pallidum (Syphillus) - Ulcer with well-defined borders
- Condyloma acuminata (HPV) - Skin coloured papules (genital warts)
- Granuloma inguinale(Klebsiella) - sharply demarcated ulcer with beefy red granulation tissue
Genital Infections that cause lesions:
‘No pain’
Syphilis the great imitator?
Syphilis - the great imitator:
- Primary
- Painless chancre
- Secondary
- Condyloma lata
- Rash on palms and soles
- Tertiary
- Gummas - is a soft, non-cancerous growth resulting from the tertiary stage of syphilis. It is a form of granuloma.
- Aortitis
- Neurosyphilis
- Argyll Robertson pupil - usually bilateral and characterised by small, irregular pupils; the size of the pupils may be unequal; absence of the light reflex; a prompt accommodation reflex; pupils slowly dilate with mydriatics.
- Diagnosis: requires two tests - Venereal Disease research lab (VDRL) and the T.pallidumpassive agglutination(TP-PA)
Genital Infections that cause lesions:
‘No pain’
Condyloma acuminata HPV (Genital warts)
Granuloma inguinale Klebsiella
- Condyloma acuminata HPV (Genital warts) - Skin coloured papules
- Granuloma inguinale Klebsiella - demarcated ulcer, beeffy red granulation
Genital Infections that cause lesions:
‘No pain’
Granuloma inguinale
Sharpley demarcated ulcer with beefy red granulation tissue
Genital Infections that cause lesions:
Painful
Genital Herpes - Vesicles
Haemophiilus ducreyi - Chancroid - Ulcer withh yellow/grey/exudate
Lymphogranuloma venereum - Chlamydia Ulcer/swollen tender/lymph nodes
